Non-Visual Access to Minnesotans Who Are Blind

The purpose of the Minnesota Employment Policy Initiative (MEPI) is to facilitate dialogue and develop leadership on disability and employment policy that will result in increased competitive employment of Minnesotans with disabilities. Partnership is key to the initiative’s success. MEPI is enlisting strategic partners from disability advocacy groups, counties, state disability councils, human resources organizations, employment services providers and other service providers, Centers for Independent Living, the University of Minnesota, businesses and business organizations and state agencies.

Together, MEPI and its partners undertake wide-ranging activities to bring together stakeholders to shape and advance public policy. They are convening “listening sessions” to be used as the basis for policy briefs identifying recommendations that will improve competitive employment outcomes for Minnesotans with disabilities around the core question, “What will it take to double employment of Minnesotans with disabilities by 2015?”

Executive Summary
A listening session on employment and individuals who are blind was hosted by the American Council of the Blind of Minnesota and the National Federation of the Blind of Minnesota on March 16, 2010. The listening session was facilitated by the Minnesota Employment Policy Initiative. Eleven participants worked to identify strategies to increase employment rates for individuals who are blind. The following recommendations were identified from the themes generated by the listening session participants:

• Increase the rate of blind people receiving “Adjustment to Blindness” training to maximize independence and self-determination with a heavy emphasis on skills needed for success in a job.

• Provide universal access to all job-related websites and software by requiring

non-visual access to Minnesotans who are blind.

• Ensure workforce centers are as accessible to blind Minnesotans as they are to

other users.

• Ensure Minnesotans who are blind have access to the technology they need to obtain and retain employment.

• Ensure transition-aged students with disabilities develop a work history through part-time employment and internships during high school and college.

• Ensure State Services for the Blind (SSB) counselors and service providers have high expectations about the capabilities of blind people and have the knowledgebase to explore the wide array of available jobs during the job development process.

• Launch a public education plan targeted toward the unprecedented education of employers about the capabilities of blind people.

• Expand self-employment services for blind Minnesotans beyond food and vending services.

• Eliminate having a driver’s license as a job requirement when driving is not an essential requirement of the job and accommodations could be provided.

• Increase funding for public transportation.

Although these recommendations were developed to address increased employment of Minnesotans who are blind, many of them would also apply to individuals with other disabilities. The Minnesota Employment Policy Initiative will be conducting nine additional listening sessions with other disability groups similar to the session on blindness. MEPI is also working with community action teams (CATs) to identify specific policy issues which support or impede these CATs as they develop customized employment for individuals throughout the state experiencing a range of disabilities.

The information gathered through the listening sessions and the employment development efforts of the CATs will be analyzed to develop a summary of commonalities. Representatives from the various listening session groups will then be reconvened to strategize on addressing the policy implications in improving employment outcomes and developing a more specific set of recommendations for action to move toward doubling the employment rate of Minnesotans with disabilities by 2015.

Background on Vision Loss
Vision loss is a general term referring to sight limitations even with corrective intervention. This includes people across the vision spectrum, from those who experience low vision to those who are totally blind.[1] There are many types of vision loss and numerous causes (see Table 1).

Table 1: Common Types of Vision Loss and Etiology

Common Types of Vision Loss / Common Etiology
Macular degeneration: The deterioration of the retina causing gradual or rapid vision loss. / Aging
Best’s Disease
Stargardt’s Disease
Heredity
Diabetic Retinopathy: A condition that
results in abnormal blood vessel development in the eye. / Diabetes
Retinitis Pigmentosa: A gradual deterioration of vision at night that can progress to total impairment. / Heredity
Retinal Detachment: The separation of the retina from the back of the eye. / Eye trauma
Infection
Tumor
Blood vessel disturbance
Glaucoma: A condition where the internal pressure in the eye damages the optic nerve, often resulting in vision loss. / Heredity
Eye trauma
Diabetes
Infection

Adapted from: (American Optometric Association, 2010;

American Foundation for the Blind, 2010b)

For many individuals, heredity is a major factor in vision loss. For others, vision loss can be a complication of health-related conditions such as diabetes, infections and trauma to the eye or head. Vision loss can occur at any age; however, many vision-related conditions develop and worsen with age.

To better understand vision loss, it is helpful to understand some of the common definitions used in the field. The American Foundation for the Blind[2]uses the following definitions:

• Visual impairment: A visual acuity of 20/70 or worse in the better eye with best correction, or a total field loss of 140 degrees. Additional factors influencing visual impairment might be contrast sensitivity, light sensitivity, glare sensitivity, and

light/dark adaptation.

• Legal blindness: A level of vision loss that has been defined to determine eligibility for benefits. The clinical diagnosis refers to a central visual acuity of 20/200 or less in the better eye with the best possible correction, and/or a visual field of 20 degrees or less. Often, people who are diagnosed with legal blindness retain some useable vision.

• Total blindness: An inability to see anything with either eye.

Current national estimates utilizing the National Health Interview Survey indicate that there are approximately 18.7 million American adults between the ages of 18 and 64 with significantvision loss.[3] Based on the 2008 American Community Survey, the American Foundation for the Blind reports a total of 68,028 Minnesotans who have vision loss, across all age groups with approximately 31,000 working-age adults and 4,000 Minnesotans ages 5 to 17.[4]

Workforce participation for working-age adults with vision loss is far less than that of the general population. According to the Bureau of Labor Statistics in April of 2010:

• Approximately 33% of people with vision loss are employed.
• Approximately 6% are seeking employment.
• 61% of people with vision loss did not participate in the workforce, i.e., they were not employed and were not seeking employment.[5]

To facilitate the employment of people with vision loss, funding is available to states from the Rehabilitation Services Administration (RSA) through Title I of the Rehabilitation Act of 1973, as amended. In 28 states, including Minnesota, there are State Vocational Rehabilitation Programs providing services solely to people who are legally blind.The remaining states provide services through a general vocational rehabilitation agency serving people who are blind in addition to all other disability groups.

The Institute on Community Inclusion at the University of Massachusetts in Boston,using databases from Rehabilitation Services Administration (RSA), reports that Minnesotans with vision loss participate in the workforce less and earn less than the national average of people with vision loss across the country.[6] RSA data shows:

• The national average of hours worked per week was 31.46 for women and 33.42 for men with vision loss. In Minnesota, women worked 27.l hours and men worked 29.38 hours per week.
• Men with vision loss in Minnesota tend to earn about $429.31, which is $35 less per week than the national average for men with vision loss. Women in Minnesota tend to earn about $377.60, which is $16 less per week than the national average for women.

A number of factors influence the employment of people with vision loss including level of education, academic skills, gender, age, race, having additional disabilities, and the severity of vision loss.[7] Research also identifies that individuals with better self-determination skills, social skills, social support, and on-the-job socialization skills were more likely to find, obtain, and retain employment.[8] Vocational rehabilitation services are also an important resource. Individuals who utilize vocational rehabilitation services to find and retain employment, and who maintain a working relationship with their vocational rehabilitation counselor, are more likely to experience positive employment outcomes.[9] For transition-age youth with vision loss, post-

school employment outcomes were correlated with having had a variety of employment experiences in high school.[10]

Experts in the field of vision loss have long believed employment outcomes were affected by whether individuals were born blind or lost their vision later in life and that these differences should be considered when developing vocational rehabilitation programs.[11] Some researchers have found that those who lost vision earlier in life were more likely to be employed competitively in a community business, at a home-based business, or through a community rehabilitation program than individuals who lost their vision later in life.[12] However, one study found no relationship between the age of vision loss and employment status.[13] Other researchers have found that having a job at the onset of disability was a more significant predictor of future employment status,[14] as were the number of jobs held prior to receiving vocational rehabilitation services.[15]

Research also identifies assistive technology and job accommodations as important to successful employment outcomes.[16] Closed circuit television (CCTV), computer screen magnifiers, audio recorders, computer screen readers, and optical scanners are examples of assistive technology that support employment outcomes. However, accessing those assistive technologies can be problematic.[17] Often access to experts in evaluating assistive technology options is not available to individuals and support providers. In addition, there is no coordinated funding mechanism to pay for assistive technology and vocational rehabilitation agencies, and employers often need to negotiate a resolution.[18] Modification of employment tests, use of personal readers, modified

employee training, mobility and orientation training, and drivers are examples of the types of accommodation that also contribute to increased employment outcomes.[19]

The importance of technology is recognized by groups such as the Coalition of Organizations for Accessible Technology (COAT), made up of over 230 organizations including the American Foundation for the Blind, which was a founding member. The Coalition advocates for greater access of internet-based technologies for individuals with disabilities and was successful in lobbying for the recently passed “Equal Access to the 21st Century Communications and Video Accessibility Act.” This legislation will improve access and could impact employment for individuals with disabilities. The Justice Department is also planning rulemaking to improve internet access.[20] However, neither of these actions is specific to improving employment outcomes so it is hard to predict their potential impact.

People experiencing vision loss face many challenges toparticipating in the workforce. Some of those challenges can be addressed through training enabling individuals to learn new skills in adjusting to blindness, such as mobility and orientation training, as well as acquiringliteracy in Braille and other adaptive skills. “Adjustment to blindness” services are often provided prior to active job development. Skills leading toward greater independence and self-determination in addition to on-the-job social skills have been shown to result in better employment outcomes.[21]

An additional challenge for individuals with vision loss is the limited choice among service providers. Few service providers have the knowledge and skills needed to facilitate job placement for individuals with vision loss.[22] Information from the Ticket to Work Program illustrates some of the challenges. Employment networks participating in Ticket to Work cite difficulties in job placement and a lack of expertise about vision loss asmajor barriers impeding their ability to successfully assist people with employment.[23] Access to reliable transportation to and from work is also cited as a significant barrier. As a result, only 10% of Employment Networksare serving individuals who experience vision loss and about 6% of the networks refuse services to people with vision loss.[24]

The attitudes, perceptions, and biases of employers about vision loss and its effects on employment are also a significant obstacle to employment opportunities. To address those concerns, some support professionals advocate strategies such as using internships, on-the-job training of employees, and utilizing on-site job coachesto demonstrate to employers the abilities of employees with vision loss.[25]

Little research has focused on best practices to improve the employment outcomes of people with vision loss. In the field there is considerable acceptance of supported employment enclaves in which the work may be performed in a community business setting, but the employees are paid and supervisedby the support provider.

The National Industries for the Blind (NIB) provides employment for people with vision loss by regularly accessing federal contracts through the Javits-Wagner-O’Day Act, which provides special access to contracts to qualifying support entities.[26] As the federal government has eliminated a number of federal positions, some of those functions have been replaced by contracting with private businesses. NIB associated agencies have become federal contractors for some of those jobs. Typically, this arrangement allows the NIB or an affiliate agency to acquire a contract and pay and support people with vision loss to perform those jobs. Some of those jobs are located in a federal setting but employees are supervised and paid by NIB associated industries. NIB uses a similar model for contracting with private businesses. Most individuals employed by NIB associated agencies earn above minimum wage but about 20% do not.[27]

The Rehabilitation Services Administration (RSA) sets performance indicators for evaluating state vocational rehabilitation programs. In 2009, State Services for the Blind (SSB) fell below the RSA standard for clients achieving their employment outcomes with 48.17% of SSB clients achieving their employment outcomes. However, of the 78 clients who did achieve their employment outcome, 98.11% were competitively employed, far exceeding the RSA standard of 35.4%. RSA also measures the earnings ratio of individuals who are competitively employed with the average hourly wage of workers without disabilities. SSB clients also exceeded the RSA

standard for earnings ratio. The RSA standard is 59 cents for every dollar earned by citizens without disabilities. SSB clients earned 67 cents for every dollar earned by other citizens.[28]

Background on Minnesota Employment Policy Initiative Listening Sessions
The Minnesota Employment Policy Initiative is conducting listening sessions in the following areas:

Brain InjuryMental Health

DeafBlindnessDeaf and Hard of Hearing

BlindnessAutism

Developmental DisabilitiesPhysical Disabilities

TransitionFamilies

Listening sessions are convened by a host organization which selects participants representing a variety of perspectives. The listening sessions are facilitated by MEPI using three questions as the framework for the sessions. The questions are designed to build upon one another creating momentum toward strategies for the final question on doubling employment.

The first question, “Why is work important?” helps a group to focus specifically on employment. It also reminds the group of the benefits work provides to individuals with disabilities and creates a positive orientation for the subsequent questions.

The second set of questions, “What’s working? What are we doing right in Minnesota?” builds on the first question, reminding participants of the many services, initiatives, and groups that are already in place or in the planning stages to improve employment outcomes. It identifies strengths on which to build and also opportunities to produce better collaboration between groups and initiatives. It also creates a shared frame of reference for the group and is usually a learning experience for group members as they share their knowledgebase about the strengths and leadership within Minnesota. The more common focus of identifying barriers often does not lead to creative strategies to address those barriers, and the negative focus on barriers can make it more difficult to brainstorm on potential strategies toward better employment outcomes.

The third question, “What will it take to double employment of Minnesotans with disabilities by 2015?” is the core question for participants. It is a question originally posed by the Alliance for Full Participation and, with their permission, adopted by MEPI. It is intended to be provocative by challenging participants to think out of the box and move toward strategies that can have a more dramatic effect on employment outcomes.

Listening Session on Blindness
A listening session on employment and individuals who are blind was facilitated by the Minnesota Employment Policy Initiative and hosted by the American Council of the Blind of Minnesota and the National Federation of the Blind of Minnesota on March 16, 2010. Eleven participants worked to identify strategies to increase employment rates for individuals who are blind. Their responses to the three questions follow.

Why is work important?

• Work is important for everyone, not just people with disabilities. It affects self-esteem and gives people the means to provide for their needs.
• Since there is a standard that people who are blind do not work, we need to prove to society that we can work.
• Working provides a sense of satisfaction. You do a good job and are recognized for it through a paycheck or other kinds of recognition.
• Society gains from our working. When people with disabilities are not expected to work, society loses our skills.
• Useful work, like useful education, is leverage you have on society since if you do not work society makes assumptions about you. We need that leverage.
• When a person with a disability works, you educate others about what you can do as a person with a disability.
• Making money is a good reason to work.
• Work makes us active consumers. It makes a difference when you earn money. We also put money back into the system that supports us through paying taxes.
• Work boosts your mental health. It gets you out of the house, completing projects, meeting deadlines, accomplishing goals and facing challenges.
• Work is important because when you meet someone for the first time, they ask, “What do you do?”

What’s working? What are we doing right in Minnesota?